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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. A method to assess changes in presynaptic inhibition of I a afferent terminals in man is proposed. The soleus H reflex was facilitated by a heteronymous I a volley from quadriceps and the amount of reflex facilitation was used to estimate the size of the conditioning I a excitatory post-synaptic potential (e.p.s.p.). It is argued that the size of this e.p.s.p. as measured by the resulting amount of reflex facilitation reflects the amount of presynaptic inhibition on the corresponding I a fibres. A decrease in the reflex facilitation may then be ascribed to an increase in presynaptic inhibition of the I a fibres mediating the conditioning volley. 2. That the heteronymous I a facilitation from quadriceps to soleus is caused by a purely monosynaptic e.p.s.p. is a prerequisite for the validity of the method. Experimental evidence is therefore given in an Appendix that in man the earliest part (first 0.5 ms) of this heteronymous I a facilitation is mediated through a monosynaptic pathway. Evidence is also given that this earliest facilitation is not yet contaminated by any polysynaptic effects from I a or I b afferents. 3. The validity of the method was established in animal experiments in which presynaptic inhibition of I a fibres and post-synaptic events in motoneurones could be assessed by direct tests. It was found that the amount of test reflex facilitation produced by a conditioning I a volley was decreased when I a fibres were subjected to presynaptic inhibition but remained unchanged when the motoneurone pool in which the test reflex was elicited received pure post-synaptic inhibition. 4. In man, presynaptic inhibition of I a fibres was evoked by a short-lasting (three shocks at 200 Hz) vibration applied to the tibialis anterior tendon. Such a vibratory burst reduced the efficiency of the heteronymous I a volley in facilitating the soleus H reflex. By contrast, during a pure post-synaptic inhibition of soleus motoneurones the efficiency of the conditioning volley in facilitating the test reflex remained unchanged. It is therefore argued that the amount of heteronymous I a facilitation can indeed be used to assess the amount of ongoing presynaptic inhibition exerted onto heteronymous I a fibres from the quadriceps muscle to soleus motoneurones. 5. The short-lasting tibialis anterior vibration used here evoked a long-lasting (300-500 ms) depression of soleus and quadriceps H reflexes.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Assessing changes in presynaptic inhibition of I a fibres: a study in man and the cat. 368 41

Using survival methods the authors review and reanalyze nine published reports on relapse after recovery from depression. Despite wide disagreement over cross-sectional rates of relapse, the reanalysis reveals a common finding that the hazard of relapse declines steadily for the first three years after recovery. Methodological and design issues are discussed and summarized for the 40 naturalistic studies that report on longitudinal outcome after recovery from depression. The principles and techniques of survival methods are briefly introduced in an Appendix.
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PMID:Relapse in affective disorders: a reanalysis of the literature using life table methods. 671 15

This double-blind, placebo-controlled, parallel-group, multicenter study was designed to evaluate the safety and efficacy of a new controlled-onset, extended-release formulation of verapamil hydrochloride called physiologic pattern release (PPR) verapamil. The study was conducted at 24 sites (13 United States, 5 Canada, 6 overseas; see Appendix). Following a 1- to 3-week single-blind placebo lead-in period, 278 patients with chronic stable angina pectoris (247 males, 31 females, mean age 60.8 years, range 32 to 78) were randomly assigned to 1 of 4 once-daily, fixed-dose treatment groups: verapamil 180, 360, or 540 mg, or placebo. PPR verapamil at all doses significantly increased (p < 0.05) time to moderate angina and symptom-limited exercise duration, and verapamil 360 mg significantly increased (p < 0.05) time to > or = 1 mm ST-segment depression, after 4 weeks of treatment when assessed 24 hour after the previous dose. Larger doses of verapamil were associated with proportionately greater improvements in exercise tolerance. Frequency of anginal attacks was also reduced by verapamil. The most frequently observed adverse events were dizziness, headache, constipation, and nausea. The incidence of constipation was high (20.9%) within the 540 mg treatment group. This verapamil formulation can be clinically titrated within a 180 to 540 mg dosing range, permitting effective once-daily administration for the treatment of chronic stable angina.
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PMID:Placebo-controlled evaluation of three doses of a controlled-onset, extended-release formulation of verapamil in the treatment of stable angina pectoris. 776 93

Recent studies have indicated the pernicious nature of dysthymia; its low-grade chronicity probably contributes most to the problem of under-treatment and misdiagnosis. A high prevalence of morbidity and comorbidity is associated with dysthymia: major depression, alcoholism, anxiety and personality disorders are present in the vast majority of sufferers. It is also very unusual for people with dysthymia to not develop superimposed episodes of major depressive disorder, resulting in a longer time to recover and high rates of recurrence and chronicity. Approximately 3.1% of the population have dysthymia including children and adolescents who, like adults, exhibit a higher risk for new episodes of depressive illness if they have this disorder. Children and adolescents with depressive illnesses have higher rates of scholastic failure and school-related problems. Dysthymia can affect every aspect of a person's quality of life including relationships with significant others, earning potential and, most importantly, mental and physical well-being. Available data is not yet sufficient to differentiate dysthymia as a disease entity from the other depressive disorders such as major depression or double depression, or to conclude to what extent dysthymia should be thought of as a personality disorder. However, the DSM-IV Mood Disorders Field Trial results help identify new criteria for the DSM-IV Appendix. The relationship between dysthymic disorder and major depression needs more definition, especially in regard to course and severity, so that an accurate diagnosis can lead to expeditious and appropriate treatment.
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PMID:Dysthymia in clinical practice:course, outcome and impact on the community. 794 65

A factor analysis (n = 183) of Marlatt's relapse taxonomy as assessed by the Reasons for Drinking Questionnaire (RFDQ) (see Appendix I, this article) was conducted using a heterogeneous alcohol treatment sample. Results indicated that the predominant factor was negative emotions. The second factor consisted of social pressure and positive emotions, and a third factor consisted of physical withdrawal, wanting to get high, testing control, substance cues and urges to drink. Each of the 13 categories in the Marlatt taxonomy loaded on one of the three factors. Scores on the first factor for the first and second lapses were correlated. The same held true for the other two factors. The negative emotions factor was positively related to blood alcohol level on the first day of the lapse, the lapse duration (in days), and occurrence of a second lapse (even when controlling for alcohol dependence). The negative emotions factor in turn was related to client reports of alcohol dependence, trait anger, and depression (all positively). Women scored higher on the first factor, and men scored higher on the second factor. The third factor was inversely related to the number of days of abstinence preceding the lapse. Taken together, these analyses, illustrate that different precipitants occur together, suggesting that clients might productively be trained in the use of specific relevant coping skills to address potential relapse precipitants. Focusing on the third RFDQ factor may be particularly important in the early stages of abstinence. The importance of anger and depression management during alcohol treatment is also highlighted by these results.
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PMID:Relapse research and the Reasons for Drinking Questionnaire: a factor analysis of Marlatt's relapse taxonomy. 899 86

Even though premenstrual symptoms had been already described by Hippocrates, premenstrual dysphoric disorder (PMDD) was first mentioned as a special psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. In DSM-III-R-Appendix A is was called late luteal phase dysphoric disorder (LLPDD), Appendix A. Before this diagnosis was established based on operationalized criteria, the term premenstrual syndrome (PMS) was used for patients with severe premenstrual mood disturbances and physical symptoms. Many hypotheses about the pathophysiological mechanisms underlying PMS and PMDS led to different therapeutic strategies. While PMS was mainly treated by gynecologists, PMDD became of interest in psychiatric research. Several antidepressants, psychotherapy, sleep deprivation and light therapy have been investigated regarding their effectiveness in combatting premenstrual symptoms such as depression, tension, dysphoria and anxiety. Within the anti-depressants the best findings were for selective serotonin reuptake inhibitors (SSRIs).
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PMID:[Premenstrual dysphoric disorder. An overview of diagnosis, epidemiology and therapeutic approaches]. 941 Dec 73

This study describes the preliminary psychometric characteristics of a new parent-as-respondent assessment tool, the Coolidge Personality and Neuropsychological Inventory for Children (CPNI). The CPNI contains 200 items answered on a 4-point Likert-type scale. The CPNI has a three-fold purpose: (a) to assess the 12 personality disorders according to the criteria on Axis II and Appendix B of the Diagnostic and Statistical Manual of Mental Disorders; (b) to assess neuropsychological dysfunction, including Attention-Deficit/Hyperactivity Disorder, Mild Neurocognitive Disorder, executive function deficits, and other related symptoms; and (c) to measure some Axis I diagnoses including Separation Anxiety Disorder, Oppositional Defiant Disorder, depression, and general anxiety, as well as other clinical syndromes. The scale reliabilities and test-retest reliabilities were moderate to high, and construct validity was good, which supports further research with the inventory.
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PMID:The Coolidge Personality and Neuropsychological Inventory for Children (CPNI). Preliminary psychometric characteristics. 1220 27

Depressive state is experienced usually in health subjects as "grief" process or "mourning work" in object loss. Also, subthreshold depression (sD) has been found to be a highly prevalent condition, with a considerable impact on the quality of life of patients, resulting in a strongly increased service utilization, and it has been found to be associated with large-scale economic costs because of disability days. A person can be considered to have sD when he or she has clinically relevant depressive symptoms, without meeting criteria for a full-blown major depressive disorder (MDD). The clinically relevant depressive symptoms in sD can either be operationalized as having a depressed mood with one or more additional symptoms of a mood disorder, or as meeting the criteria of minor depression (mD), as defined in the Appendix of the DSM-IV. Assessing the incidence of MDD in patients exhibiting sD is important for several reasons. First, it is an important indicator for the clinical relevance of sD. Secondly, it is important for understanding the process by which an individual develops MDD and the role of depressive symptoms in the process. Thirdly, the increased risk is important because it may provide a rationale for the development of new interventions that prevent the onset of new cases of MDD. Several recent studies in this area have found evidence that it is indeed possible to reduce the number of new cases of MDD by intervening in subjects with sD.
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PMID:[Differential diagnosis of depressive state]. 1787 84

Depressive personality disorder (DPD) is currently included in the DSM-IV Appendix B, Criteria Sets and Axes Provided for Further Study. Evidence of the clinical utility of DPD will likely play an important role in the determination of whether it warrants inclusion in future editions of DSM. The current investigation examines the capacity of DPD traits to predict overall and preferential treatment outcome for patients with Major Depressive Disorder (MDD) (N = 120) using data from a randomized control trial, which included cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and antidepressant medication (ADM) treatment arms. Patients were treated for 16-20 weeks and completed the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Questionnaire (SCID-II/PQ) and the 17-item Hamilton Rating Scale for Depression immediately before and after treatment. Higher scores on a dimensionalized SCID-II/PQ subscale assessing DPD traits were associated with poor outcome for IPT, but not CBT or ADM. This result remained after accounting for variance associated with other personality disorder (PD) traits; none of the other 10 main text PDs predicted treatment outcome.
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PMID:Depressive personality and treatment outcome in major depressive disorder. 2054 2

Chronification of migraine headaches is one of the most urgent issues. Chronic migraine (CM) and medication overuse headache (MOH) are defined in international classification of headache disorders II (ICHD-II). Appendix criteria of CM and MOH were submitted and will take over the original criteria. I described a case of CM and a case of MOH. Here I pointed out some practical issues in diagnosis of CM or MOH. 1) It is not easy to define the association of headache worsening and the beginning of medication overuse in many cases. 2) Some patients cannot discontinue the overused drugs; therefore, the diagnosis of CM nor MOH cannot be completed. 3) Some patients are not released from their headache even after the discontinuation of drug. In these cases, there are two possibilities. As a result of CM, the patient had simply overused the ineffective medications. From another point of view, MOH caused irreversible brain changes and MOH do not disappear after the detoxification. 4) In a practical management, we often prescribe preventive medications simultaneously at the beginning of detoxification. In these cases, it is unclear which one of the detoxification or the preventive medication contributes the improvement of headache. The chronification of migraine is regarded as chronification of acute mechanism of migraine, i.e., inflammation of the trigeminovascular system and sensitization of the brain. Apart from medication overuse, there have been reported some new risk factors for migraine chronification, including frequent headache, female sex, obesity, low income, low education, stress by life events, depression, snoring, sleep disorders, and past history of neck or head injury. Chronification of migraine severely disturbs the quality of patient's life. More attention should be paid and the further and extensive studies are urgently necessary.
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PMID:[Clinical features and mechanisms of chronic migraine and medication-overuse headache]. 2192 39


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